2. Acknowledgements
2
— Thesis Advisory Committee:
¡ Dr. Christopher C. Yang (chair)
¡ Dr. Jennifer Unger
¡ Dr. Jung-Ran Park
¡ Dr. Margo Orlin
¡ Dr. Weimao Ke
3. Pensieve
“One simply siphons
the excess thoughts
from one's mind, pours
them into the basin,
and examines them at
one's leisure. It
becomes easier to spot
patterns and links, you
understand, when they
are in this form.”
— Albus Dumbledore to
Harry Potter (4th book
of series, Chapter 30)
3
5. And you click on the first result…
5
— Hmm.. Megan has the
same question as me.
— 5 replies…
¡ Personal stories given
¡ Book recommendations
6. Possible Reaction to the UI
6
“I wonder if that advice would apply to me…”
“Gosh, I don’t feel comfortable responding to the
whole group…”
— There are different facets of communication
(Farnham and Churchill, 2011)
9. 9
Online Health Social Networking
“e-patients are looking for ‘just-in-time someone-
like-me’
health information”
- Boase et al, 2006; Fox & Jones, 2009
*E-patient: internet user that is looking for health information
“e-patients are looking for a sense of community”
-Wright & Bell, 2003
41%
read patient blog,
health newsgroup,
or health website
39%
used social
networking site
12%
shared updates or
viewed updates
10. Significance of Study
10
— Previous research has different perspectives:
¡ Issues that concern Health Professionals
¡ Issues that concern E-Patients
¡ Issues that concern Health Records
— Expand scholarly literature
¡ Compared CMC formats within one online community.
¡ Use mixed techniques for samples.
— Fill limitations in previous work
¡ There are still gaps in understanding the technology.
12. Theoretical
Framework =
Technical and
Social factors
Online communities are a
combination of technical
and social factors
(Latour, 1992; Preece,
2000).
Members communicate
through text-based
computer mediated
communication (CMC)
formats.
Support communities are
composed of people who
are building relationships
and exchanging social
support.
12
13. Research Themes
— Observations:
¡ Some users are more active, others lurk
¡ Some are new to community
¡ Social roles (i.e. alcoholic, friend of alcoholic)..
— CMC formats have different features
÷ Who can write? read? Where is the message saved?
13
14. Research Method Part 1
14
— Reveal interaction patterns in user content
— Social media is used by health consumers to …
¡ Communicate health information
¡ Share social support
¡ Build friendships with each other
— Significance of studying e-patient interactions
• Reports show that internet use for health information is
growing (Kielstra, 2009; PEW Research Ctr, 2006, 2009,
2010)
15. Medhelp.org
“connects people with
the leading medical
experts and others who
have similar experiences”
“helping patients find
answers to their questions”
“helping patients actively
manage their health”
• Founded in 1994
• Oldest online community
• Pioneer of online health
communities
• 10 mil monthly visitors
15
17. Related studies only focus on one CMC
17
Author Data Type
Preece (1999) Torn Knee Ligament Email List
Braithwaite et al (1999) “Support Network” Email List
Bambina (2007) Support OnLine
Cancer Forum
Email List (stored online)
Meier et al (2007) 10 cancer mailing lists Mailing lists
Pfiel & Zaphiris (2007) Depression/Seniors
Bulletin Board
Cunningham et al
(2008)
Alcoholism Bulletin Board
Eichhorn (2008) Eating Disorder msg
boards
Yahoo Discussion Groups
Coursaris & Liu (2009) HIV/Aids Bulletin Board
McCormack (2010) Anorexia Bulletin
Board
Bulletin Board
Selby et al (2010) Smoking cessation Web assisted tobacco
intervention, bulletin board
18. Objective
— Understand prevalence and characteristics of
different support types that peers exchange.
¡ Categories come from literature review on social support
¡ Categorize messages into support types
÷ Dimensions:
¢ Offered vs requested
¢ Post vs comments
18
19. Research Theme 1
19
Research
Question
• RQ1: What social support patterns exist in messages
exchanged by members of an online health community?
Objective
• Study the patterns of social support exchanges of 3
CMC formats: Forums, Journals, Notes
Approach
• Descriptive Content Analysis
• Coding: social support types for each message
21. Approach
1. Data source = MedHelp.org Alcoholism
2. Data collection = crawler
3. Unit of analysis = each message
4. Convert text files to Excel spreadsheets
5. Time Frame:
1. 9th June 2009 – 9th September 2009
21
22. Informational Support
Support Definition Example
Advice Offers ideas and suggests actions
to deal with situation (Cutrona &
Suhr, 1992).
“Campral works better...ask u r doc
about it!”
Referral Refers the recipient to some
other source of help.
“Im gonna send you a link that
might help.”
Fact reassesses the situation and
presents facts.
“Drinking too much alcohol daily
can be a high risk to your health,
you might fall into alcohol
addiction.”
Personal
experience
stories about person’s
experiences.
“I have been going though
something like that with an addict
using in our bathroom and….”
Feedback /
Opinion
a view or judgment formed about
something, not necessarily based
on fact or knowledge.
“From what have you posted, it
seems that you are in the stage
where you have been looking to
drink everyday and it is a clear sign
of alcohol addiction.”
22
23. Nurturant Support
Support Definition Example
Esteem posts providing positive
comments to praise support
seekers abilities or to alleviate
feelings of guilt.
“Congratulations on your
sobriety!”
Network posts providing messages to
broaden support seekers social
network so they don’t feel
alone.
“Just reach out and I will be there
ok?”
Emotional posts providing understanding
of situation, express sorrow,
provide with hope and
confidence.
“You're going through a rough
time....” or “Hang in there hon”
23
26. 3. Coding
posting for self (M); friend (B); family
member (F); spouse (S); sig other (SO).
0 = Offered; 1 = Request; 2 = both
26
27. What patterns of social support exchanged emerge?
27
1 –High amount of msgs offered informational support
2 –High amount of msgs offered nurturant support
3 –Low amount of msgs requested supports
29. People want to stay in touch
29
“Positive comments are observed between MySpace friends”
-Thelwall & Wilkinson, 2010
“Friending enables users
to form and maintain
connections”
- Ahn et al, 2007 “Private and public messaging allow
for interpersonal communication”
- Thellwall & WIlkinson, 2010
“SNS users expect to gratify their social-emotional needs”
- Rau et al, 2008
30. Health Social Networking
30
— Health Context…
¡ Hundreds of support communities
÷ Cancer, pregnancy, mental health, substance abuse, etc.
¡ More features than old software:
÷ Bulletin Boards (BB), email lists, discussion boards, blogs, etc.
÷ ‘Friending’ and status updates, notes
31. Research Theme 2
31
Research
Question
• RQ2: What social network structure patterns emerge in
messages exchanged by members of an online health
community?
Objective
• Study the patterns of social support exchanges of 3
CMC formats: Forums, Journals, Notes
Approach
• Social Network Analysis
• Metrics: structural and positional
33. Part 2: Social Network Analysis
33
— Structural Metrics
¡ Centrality Measures: gives a rough indication of a person’s
"connectedness" the network.
÷ In Degree: the number of people that talk to him/her
÷ Out Degree: the number of people he/she talks to
¡ Geodesic Distance = shortest distance between two specific nodes
¡ Density = number of edges / number of nodes
— Positional Metric
¡ id different roles of a group setting
— Positional analysis to Know range of roles and
characteristics to make recommendations for designing a
social support system that is suitable for users
34. Centrality
34
— Betweenness = the number of people who a person is
indirectly connected (i.e. controls flow of
information)
— Eigenvector = influence of a node
— Closeness = based on shortest paths; measures
distance to spread information from a node x to all
other nodes sequentially
35. Some Insights
35
— Forum:
¡ User reach out to a wider group of people and hold group
conversations.
¡ They tend to be on receiving end.
— Journal:
¡ Tend to be writing messages and to a smaller audience
— Notes:
¡ Less overlapping connections, one to one conversations
37. Social Positions
37
— Isolates: nodes with neither indegree nor outdegree
— Transmitters: nodes with only outdegree
— Receivers: nodes with only indegree
— Carriers: nodes with both indegree and outdegree.
38. Configurations of Ties between Social Positions
38
Tie Meaning
Self loop
A single cohesive subgroup and an
isolated position
One tie between positions
Transmitting end is providing support
Receiving end is requesting support
Self loop for each position
Two subgroups
Two ties from node: self loop and
regular tie
Distinguishes between an “active”
position and a “passive position”
Two ties to node: self loop and regular
tie
Resembles a core-periphery system. The
position of more indegrees has been
around longer than the other position.
43. Selected Publications
43
— K. Chuang and C. C. Yang, “Interaction Patterns of Nurturant
Support Exchanged in Online Health Social Networking”
Journal of Medical Internet Research 2012; 14(3):e54. URL:
http://www.jmir.org/2012/3/e54/
— K. Chuang and C. C. Yang, “Informational Support Exchanges
on Different Computer-mediated Communication Formats in
a Social Media Community of Alcoholism” Journal of
American Society for Information Science & Technology
(forthcoming)
— K. Chuang and C. C. Yang, “How Do E-Patients Connect
Online? A Study of Social Support Roles in Health Social
Networking.” Conference for Social Computing, Behavioral
Modeling and Prediction (SBP 2013), Washington, DC.
volume 7812. p:193-200. doi: 10.1007/978-3-642-37210-0_21
44. Contributions
44
— Recommendations to design online intervention
program
¡ Assists efforts to promote healthy behaviors
¡ Identifying these users would be useful for targeting
messages to segmented groups
— Show that people still behave in a way parallel to
offline world
— Multiple techniques to find new patterns in use of
CMC formats
¡ Compares multiple CMC formats within an online community
(rather than across communities)
45. Discussion: Participation
45
— Participation influenced by social-psychological reasons…
¡ information needs, desire to be altruistic, stigmas
¡ Social Roles (i.e. caretaker, patient, nurse, friend, etc)
— The more time people spend in an online group, the larger
their online social network and the higher the satisfaction
with the received support.
46. Early Web 2.0 Social Network Sites
— Elements:
¡ Post a group message
— Shared community
— Examples: Discussion
boards, Email lists,
Q&A
— Elements
Profile + Declare people as
friends + Write Public
comments
— Ego-centric community
— Examples: twitter,
facebook, myspace
Discussion: New Media
46
47. Discussion: Technology Design
— SNS software design emphasizes relationships
— SNS give users a sense of egocentric community
— Inherent design differences – relationship structure,
communication properties
— SNS can be used for healthcare needs to stimulate
relationships between users.
— Some formats such as Journal/Notes lead to greater
levels of intimacy and stronger social support
— Virtual support complements real-life social
relationships with fewer stigmas
47
48. Limitations
48
— Cannot generalize alcoholism community to other
health conditions.
— Content analysis technique can be made stronger
¡ i.e. use Key Phrases for content analysis to have reproducible
results
49. T H A N K Y O U .
C O N T A C T :
@ K A T Y C H U A N G O N T W I T T E R
49
The End.
